Abstract: TH-OR145
Ultrafiltration and Cerebral Microbleeds in Haemodialysis Patients
Session Information
- Vascular Access and Complications of Hemodialysis
November 07, 2019 | Location: 201, Walter E. Washington Convention Center
Abstract Time: 05:54 PM - 06:06 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Qian, Yujun, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Dongcheng District, Beijing, BeiJing, China
- Zheng, Ke, Peking Union Medical College Hospital, Beijing, China
- Li, Xuemei, Peking Union Medical College Hospital, Beijing, China
Background
Ultrafiltration of dialysis patients were variable. The detailed studies on the impact of different ultrafiltration are still rare. Variable ultrafiltration may contribute to brain lesions by inducing hemodynamic instability. Cerebral microbleeds (CMBs) in dialysis patients have recently attracted much attention. The risk factors of CMB in dialysis patients are not very clear. The association of dialysis ultrafiltration with CMB is unknown.
Methods
A total of 119 chronic haemodialysis patients were enrolled in our study. Demographic and Clinical Characteristics of Patients were recorded. Multiple ultrafiltrate information of every patient before MRI examination was recruited with Ultrafiltrate volume(UV) mean, UV standard deviation(SD), UV coefficient of variation(CV), the difference between UV mean and 6% of weight, the ratio of UV to weight mean, and the ratio of UV to weight SD. CV was calculated as the ratio of SD to the mean. CMBs were defined as small (2–10 mm) areas of homogeneous signal loss on susceptibility weighted imaging images. The correlation between ultrafiltration and CMB was investigated by logistic regression analysis.
Results
Recorded dialysis period ranged from 2.0 to 14.0 months, and recorded dialysis times ranged from 11.0 to 54.0. Urea removal ratio was 0.7±0.1, and Kt/V was 1.4±0.2. UV mean ranged from 0.2 to 4.6 kg, and UV CV ranged from 0.0 to 78.1 percent. The prevalence of CMBs was 35.3% in the total study population. Ten subjects (8.4%) suffered lobar CMBs, Nine subjects (7.6%) suffered mixed CMBs, and 23 subjects (19.3%) suffered deep group. UV mean, the difference between UV mean and 6% of weight, and the ratio of UV to weight mean were risk factors of CMB (OR=1.59, 1.48, and 1.31 respectively, p=0.031, 0.042, and 0.039 respectively) and mixed CMB (OR=2.23, 2.07, and 1.66 respectively, p=0.036, 0.057, and 0.030 respectively). UV CV was negatively associated with CMB(OR=0.96, p=0.022 respectively). The association of UV mean and UV CV with CMB was still significant after adjusting for gender, age, serum albumin, urea removal ratio, lacunes, and white matter hyperintensity(OR=1.72 and 0.96 respectively, p=0.044 and 0.046 respectively).
Conclusion
UV was closely associated with CMB in dialysis patients. Reducing UV may protect dialysis patients from CMB.